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Bundle Branch Block

Shu Lih Oh, Eddie Y K Ng, Ru San Tan, U Rajendra Acharya
Arrhythmia is a cardiac conduction disorder characterized by irregular heartbeats. Abnormalities in the conduction system can manifest in the electrocardiographic (ECG) signal. However, it can be challenging and time-consuming to visually assess the ECG signals due to the very low amplitudes. Implementing an automated system in the clinical setting can potentially help expedite diagnosis of arrhythmia, and improve the accuracies. In this paper, we propose an automated system using a combination of convolutional neural network (CNN) and long short-term memory (LSTM) for diagnosis of normal sinus rhythm, left bundle branch block (LBBB), right bundle branch block (RBBB), atrial premature beats (APB) and premature ventricular contraction (PVC) on ECG signals...
June 5, 2018: Computers in Biology and Medicine
Lyda Z Rojas, Marija Glisic, Laura Pletsch-Borba, Luis E Echeverría, Wichor M Bramer, Arjola Bano, Najada Stringa, Asija Zaciragic, Bledar Kraja, Eralda Asllanaj, Rajiv Chowdhury, Carlos A Morillo, Oscar L Rueda-Ochoa, Oscar H Franco, Taulant Muka
BACKGROUND: Chagas disease (CD) is a major public health concern in Latin America and a potentially serious emerging threat in non-endemic countries. Although the association between CD and cardiac abnormalities is widely reported, study design diversity, sample size and quality challenge the information, calling for its update and synthesis, which would be very useful and relevant for physicians in non-endemic countries where health care implications of CD are real and neglected. We performed to systematically review and meta-analyze population-based studies that compared prevalence of overall and specific ECG abnormalities between CD and non-CD participants in the general population...
June 2018: PLoS Neglected Tropical Diseases
Marc Strik, Sylvain Ploux, Peter R Huntjens, Uyên Châu Nguyên, Antionio Frontera, Romain Eschalier, Remi Dubois, Philippe Ritter, Nicholas Klotz, Kevin Vernooy, Michel Haïssaguerre, Harry J G M Crijns, Frits W Prinzen, Pierre Bordachar
BACKGROUND: Electrocardiographic mapping (ECM) expresses electrical substrate through magnitude and direction of the activation delay vector (ADV). We investigated to what extent the response to cardiac resynchronization therapy (CRT) is determined by baseline ADV and by ADV modification through CRT and optimization of left ventricular (LV) pacing site. METHODS: ECM was performed in 79 heart failure patients (4 RBBB, 12 QRS < 120 ms, 23 non-specific conduction delay [NICD] and 40 left bundle branch block [LBBB])...
June 6, 2018: International Journal of Cardiology
Hong-Xia Niu, Michael R Gold
No abstract text is available yet for this article.
June 8, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Alessandro Zorzi, Manuel De Lazzari, Giulio Mastella, Alice Niero, Domenico Trovato, Alberto Cipriani, Francesco Peruzza, Leonardo Portolan, Giampaolo Berton, Federco Sciacca, Saverio Tollot, Chiara Palermo, Roberto Bellu, Flavio D'ascenzi, Denisa Muraru, Luigi Paolo Badano, Sabino Iliceto, Maurizio Schiavon, Martina Perazzolo Marra, Domenico Corrado
BACKGROUND: Whether ventricular arrhythmias (VAs) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of VAs in young competitive athletes. METHOD AND RESULTS: We studied 288 competitive athletes (age range, 16-35 years; median age, 21 years) and 144 sedentary individuals matched for age and sex who underwent 12-lead 24-hour ambulatory electrocardiographic monitoring...
June 9, 2018: Journal of the American Heart Association
S A M Compiet, R T A Willemsen, K T S Konings, H E J H Stoffers
BACKGROUND: Performing electrocardiography is common in general practice, but the quality of indication setting and diagnostic accuracy have been disputed. OBJECTIVES: To assess the competence of general practitioners (GPs) in their decision-making process with regard to recording and interpreting an electrocardiogram (ECG) and evaluating the relevance of the result for management. METHODS: An online case vignette survey was performed among GPs and cardiologists (in 2015)...
June 7, 2018: Netherlands Heart Journal
Wouter M van Everdingen, Alwin Zweerink, Maarten J Cramer, Pieter A Doevendans, Uyên Châu Nguyên, Albert C van Rossum, Frits W Prinzen, Kevin Vernooy, Cornelis P Allaart, Mathias Meine
BACKGROUND: Previous studies indicated the importance of the intrinsic left ventricular (LV) electric delay (QLV) for optimal benefit to cardiac resynchronization therapy. We investigated the use of QLV for achieving optimal acute hemodynamic response to cardiac resynchronization therapy with a quadripolar LV lead. METHODS AND RESULTS: Forty-eight heart failure patients with a left bundle branch block were prospectively enrolled (31 men; age, 66±10 years; LV ejection fraction, 28±8%; QRS duration, 176±14 ms)...
March 2018: Circulation. Arrhythmia and Electrophysiology
Takumi Yamada, Naoki Yoshida, Silvio H Litovsky, Taihei Itoh, Harish Doppalapudi, G Neal Kay
BACKGROUND: This study investigated the prevalence, electrocardiographic and electrophysiological characteristics, and ablation outcome of idiopathic ventricular arrhythmias (VAs) originating from the infundibular muscles (IFMs) in the right ventricle consisting of the parietal band (PB) and septal band (SB). METHODS AND RESULTS: We studied 19 patients with idiopathic VA origins in the PB in 14 and SB in 5 among 294 consecutive patients with VA origins in the right ventricle...
March 2018: Circulation. Arrhythmia and Electrophysiology
Leonardo Kapural, Suneil Jolly, Joao Mantoan, Harish Badhey, Ty Ptacek
BACKGROUND: Chronic hip joint pain is a common condition with an estimated prevalence of 7% in men and 10% in women, in a population sample aged over 45. Conservative treatment can include physical therapy, weight loss, a variety of pharmacologic agents ranging from nonsteroidal antiinflammatory drugs (NSAIDS) to opioids, and intraarticular injections with various substances. Definitive treatment of hip pain, however, has primarily centered on hip arthroplasty. OBJECTIVE: We describe a novel anterior approach to cooled radiofrequency (RF) hip denervation under combined ultrasound (US) and fluoroscopy guidance to avoid the neurovascular femoral bundle and reach proper landmarks...
May 2018: Pain Physician
Emilie Laflamme, François Philippon, Kim O'Connor, Jean-François Sarrazin, Vincent Auffret, Vincent Chauvette, Michelle Dubois, Pierre Voisine, Sébastien Bergeron, Mario Sénéchal
Guidelines for cardiac resynchronization therapy (CRT) have been established, but there may be a subgroup of patients not identified in these guidelines who may benefit from this therapy. We report a patient with a dynamic left ventricular dyssynchrony and severe mitral regurgitation caused by exercise successfully treated with CRT. Exercise testing should be considered in patients with left ventricular ejection fraction <35% and QRS <130 ms with severe heart failure symptoms that are unexplained by rest echocardiography evaluation in order to rule out ischemia and/or dynamic left ventricular dyssynchrony...
2018: International Medical Case Reports Journal
Maria A Baturova, Valentina Kutyifa, Scott McNitt, Bronislava Polonsky, Scott Solomon, Jonas Carlson, Wojciech Zareba, Pyotr G Platonov
Cardiac resynchronization therapy (CRT) has proven prognostic benefits in patients with heart failure (HF) with left bundle branch block (LBBB) QRS morphology. Electrocardiographic left atrial (LA) abnormality has been proposed as a noninvasive marker of atrial remodeling. We aimed to assess the impact of electrocardiographic LA abnormality for prognosis in patients with HF treated with CRT. Baseline resting 12-lead electrocardiograms recorded from 941 patients enrolled in the CRT arm of the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy was processed automatically using Glasgow algorithm, which included automated assessment of P-wave terminal force in lead V1 (PTF-V1 ) as a marker of LA abnormality...
April 11, 2018: American Journal of Cardiology
Benjamin M Scirica, Sameer Bansilal, Farideh Davoudi, Paul W Armstrong, Robert M Clare, Phillip J Schulte, Karen S Pieper, Richard C Becker, Stefan K James, Robert F Storey, Philippe Gabriel Steg, Claes Held, Anders Himmelmann, Kenneth W Mahaffey, Lars Wallentin, Christopher P Cannon
BACKGROUND: Although bradyarrhythmias have been observed with ticagrelor and its use with advanced atrioventricular block is not recommended, questions arise regarding its use in patients with mild conduction abnormalities. The objectives were to compare rates of clinically relevant arrhythmias in relation to any mild baseline conduction abnormality in patients with acute coronary syndrome randomized to ticagrelor versus clopidogrel. METHODS: We included all subjects in the electrocardiographic (ECG) substudy of the Platelet Inhibition and Patient Outcomes trial, excluding those with missing baseline ECG or with a pacemaker at baseline (N = 15,460)...
May 7, 2018: American Heart Journal
Evan C Adelstein, Andrew D Althouse, David Schwarzman, Sandeep K Jain, Prem Soman, Samir Saba
BACKGROUND: Patients with non-specific intraventricular conduction delay (IVCD) benefit less from cardiac resynchronization therapy (CRT) than patients with left bundle-branch block (LBBB). OBJECTIVE: To determine whether post-CRT outcome differences in patients with ischemic cardiomyopathy (ICM) relate to intrinsic QRS pattern and/or scar burden. METHODS: We analyzed 393 consecutive ICM patients with LVEF ≤35%, QRS duration >120 ms, and LBBB or non-specific IVCD who underwent single-photon emission computed tomography myocardial perfusion imaging and CRT-defibrillator implant...
May 28, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Ai Goto, Yuji Nakamura, Nur Jaharat Lubna, Koki Chiba, Mihoko Hagiwara-Nagasawa, Hiroko Izumi-Nakaseko, Kentaro Ando, Atsuhiko T Naito, Atsushi Sugiyama
Lithium is one of the classical drugs that have been widely used for treating bipolar disorder. However, several cardiac side effects including sick sinus syndrome, bundle branch block, ventricular tachycardia/fibrillation, non-specific T-wave abnormalities in addition to Brugada-type electrocardiographic changes have been noticed in patients who were given antidepressant, anticonvulsant, and/or antipsychotic drugs besides lithium. In this study, we assessed cardiohemodynamic and electrophysiological effects of lithium carbonate by itself to begin to analyze onset mechanisms of its cardiovascular side effects...
May 29, 2018: Cardiovascular Toxicology
Marek Jastrzębski, Piotr Kukla, Roksana Kisiel, Kamil Fijorek, Paweł Moskal, Danuta Czarnecka
BACKGROUND: Left bundle branch block (LBBB) is considered an important prognostic parameter in cardiac resynchronization therapy (CRT). We aimed to evaluate, in a sizeable cohort of patients with CRT, long-term mortality, and morbidity according to four different electrocardiographic definitions of LBBB. METHODS: This longitudinal cohort study included consecutive patients who underwent CRT device implantation in our institution in years 2006-2014. Two endpoints were assessed: (a) death from any cause or urgent heart transplantation, and (b) death from any cause or heart failure admission...
May 28, 2018: Annals of Noninvasive Electrocardiology
Abdul Sami, Malik Faisal Iftekhar, Imran Khan, Rafiullah Jan
Objective: To determine the frequency of intraventricular dyssynchrony among patients with left bundle branch block. Methods: The study was conducted at Hayatabad Medical Complex, Peshawar, from January, 2017 to July, 2017. All patients aged 18 years and above with Left Bundle Branch Block (LBBB) on ECG with or without heart failure were included in the study. Patients with valvular heart disease, predominant diastolic heart failure, acute coronary syndromes or coronary revascularization in last three months and atrial fibrillation were excluded...
March 2018: Pakistan Journal of Medical Sciences Quarterly
Mehmet Uğurlu, Onur Kaypakli, Durmuş Yıldıray Şahin, Yahya Kemal Içen, İbrahim Halil Kurt, Mevlüt Koç
AIM: The presence of subclinical atrial fibrillation (SCAF) is relevant to issues such as the risk of stroke and the necessity of anticoagulant use in patients with cardiac resynchronization therapy (CRT). Our study aimed to investigate SCAF frequency and associated parameters in patients with CRT. METHODS: One hundred ninety-one patients with CRT (77 females, 114 males, mean age 65.9 ± 9.8) were included in the study. Atrial high-rate episodes detected by the device, atrial electrode impedance, P-wave sense amplitude, and atrial lead threshold values were measured during pacemaker controls...
May 26, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Leonardo Calò, Annamaria Martino, Emilia Goanta, Yasuo Okumura, Ermenegildo de Ruvo
Right bundle branch block is relatively frequent in the general population and is generally considered benign in healthy individuals. However, it has been associated with increased cardiovascular risk and all-cause mortality in various cohort studies. Indeed, the presence of right bundle branch block in subjects affected by cardiomyopathies or channelopathies is not rare and may conceal underlying electrocardiographic changes, thus making the diagnosis of such conditions more challenging. The purpose of this review is to analyze the prevalence and clinical significance of right bundle branch block in subjects affected by Brugada syndrome and arrhythmogenic right ventricular cardiomyopathy...
May 26, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Won-Keun Kim, Helge Möllmann, Christoph Liebetrau, Matthias Renker, Andreas Rolf, Philippe Simon, Arnaud Van Linden, Mani Arsalan, Mirko Doss, Christian W Hamm, Thomas Walther
OBJECTIVES: The aim of this study was to perform a comprehensive analysis of factors that affect procedural outcomes of transcatheter aortic valve replacement using the ACURATE neo prosthesis (Symetis/Boston, Ecublens, Switzerland). BACKGROUND: Predictors of procedural outcomes using the ACURATE neo prosthesis are poorly understood. METHODS: A total of 500 patients underwent transfemoral aortic valve replacement with the ACURATE neo prosthesis...
May 21, 2018: JACC. Cardiovascular Interventions
Brian A Houston, J Lacy Sturdivant, Yinghong Yu, Michael R Gold
BACKGROUND: Controversy remains regarding the utility of cardiac resynchronization therapy (CRT) in heart failure patients with right bundle branch block (RBBB) and reduced left ventricular ejection fraction. Moreover, little is known regarding the acute hemodynamic changes with CRT in this subgroup compared with LBBB. OBJECTIVE: To understand the effects of cardiac resynchronization therapy (CRT) in RBBB patients, this study evaluated the acute biventricular hemodynamic response of CRT and other pacing configurations, including the effects of AV delay and atrial pacing METHODS: Forty patients (9 with RBBB and 31 with LBBB) undergoing CRT implantation underwent temporary pacing with varying configurations and AV delay...
May 22, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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